Employer Resources

Thank you for partnering with Sanford Health Plan (SHP) for your employer group benefits! Below are key resources and reminders to help ensure a smooth transition to our health plans.

Prescriptions

Formulary access: Your group will use an SHP commercial formulary. View details.

Prior authorization: Certain medications require approval from the prescribing provider. Download the pharmacy prior authorization list.

Preventive medications: Many HSA-qualified HDHP plans include preventive medications starting at $5. Check pricing on our prescription drug list on OptumRx.

• Tip: If possible, fill prescriptions before your plan’s effective date to avoid delays.

ID cards

Effective date: Employees can use their new ID cards starting on their plan’s effective date.

If a card hasn’t arrived:

• Access a mobile ID card through a mySanfordHealthPlan account. For more information, download our flyer.
• Request a temporary ID card from your account manager if a member has an appointment or prescription before the physical card arrives.

Members living outside the Sanford Health Plan service area

National network: SHP’s wrap network (MultiPlan/PHCS) provides in-network rates for members living outside ND, SD, NW IA, or Western MN.

Dependents living elsewhere: Employees with dependents outside the service area should complete the out-of-area validation form (includes college students, children with another parent/guardian, or adult children living out of state).

• Note: Members on the Sanford TRUE plan must receive routine care within the service area.

Prior coverage

SHP will hold claims for up to 60 days while awaiting deductible/out-of-pocket maximum credit reports from your prior carrier. Contact the prior carrier to send this report promptly.

If needed sooner, SHP can accept an Explanation of Benefits (EOB) instead.